Effective Date: April 1, 2008

(Refer to applicable Travel Directive Appendices A, B, C and D, as well as Foreign Service Directive Appendices B- U.S.A., B-International

Note:  This document is intended only as a tool to facilitate discussion between the employee and authorizing manager prior to travel status. This tool may be subject to change.

Blanket Travel Authority - FISCAL YEAR: ________________________________

Blanket Travel Authority Tracking Number: _______________________________

Employee Name: __________________________________________________

Department: ______________________________________________________

Employee Signature: ________________________ Date (y/m/d): ____________

Delegated Manager Signature: ________________ Date (y/m/d): _____________

Blanket Travel Authority Geographic Location: ____________________________

Start Date (y/m/d): ___________________ End Date (y/m/d): ________________

Maximum number of consecutive travel days: _____________________________

Maximum dollar value/limitation for each individual trip: _____________________

Travel Advance: YES___ NO___ Specified Travel Advance Amount Limit: _______

Trip Purpose: _____________________________________________________

Article Ref.


Yes = Y
No = N


3.2.1 Accommodation


3.2.2 Additional business expense   Facsimiles
      Health Certificate (Health Canada)
      Internet connections
      Office equipment - rental
      Office equipment - transportation
      Entry documents (CanPass)
      Entry documents (NEXUS)
      Photos - passport and/or visa
      Required personal effects
      Service charge - Automated Banking Machine
      Service charge - bank/financial institution commission
      Service charge - credit/debit card usage
      Service charge - government travel card usage
      Service charge - safety deposit box
      Service charge - traveller's cheques
      Telephone expenses (business calls)
      Telephone expenses (due to altered schedule/itinerary)
      Word processing services
      Business expense - Other
3.2.3 Bottled Water   Bottled water - reasonable amounts of bottled water (based on receipts).
3.2.4 Currency exchange   Commission charged
      Conversion gain
      Conversion loss
      Fee - Automated Teller Machine service charge
      Fee - service charge
      Fee - travel card usage charge
      Currency Exchange - Other
3.2.5 Dependant care   Up to $35 Cdn, per household per day
      Up to $75 Cdn maximum, per household, per day
      Other - Provide explanation
3.2.6 Home Communication


3.2.7 Incidental Allowance


3.2.8 Insurance


3.2.9 Meals   Daily Comprehensive allowance
      Breakfast - meal allowance Appendix C or D, as applicable
      Breakfast - prepaid (e.g. conference, flight, voucher, included in room rate, etc.)
      Breakfast - High Meal Cost
      Breakfast - receipted amount
      Breakfast - Other
      Lunch - meal allowance Appendix C or D, as applicable
      Lunch - prepaid (e.g. conference, flight, voucher, included in room rate, etc.)
      Lunch - High Meal Cost
      Lunch - receipted amount
      Lunch - Other
      Dinner - meal allowance Appendix C or D, as applicable
      Dinner - prepaid (e.g. conference, flight, voucher, included in room rate, etc.)
      Dinner - High Meal Cost
      Dinner - receipted amount
      Dinner  - Other
3.2.10 Rest periods


3.2.11 Transportation   Disrupted travel pattern (residence to workplace)
      Docking fees
      Transportation fees - (not otherwise paid)
      Parking - hotel, motel or corporate residence
      Parking lot
      Parking meter
      Transportation prepaid
      Passenger - no charge
      Tolls (e.g. road, tunnel, bridge)
      Airfare - Airport Improvement Fee (not included in ticket)
      Airfare - business class (non-standard) paid by traveller
      Airfare - departure taxes (not included in ticket)
      Airfare - departure taxes (not included in ticket)
      Airfare - military equipment/flight
      Airfare - business class prepaid by Government of Canada
      Airfare - economy class prepaid by Government of Canada
      Airfare - private plane (e.g. rental / charter)
      Airfare - seat selection fee for commercial, private and chartered carriers
      Airfare - Security Charges (not included in ticket)
      Airfare - unused segment(s)
      Bus charter
      Bus (inter-city)
      Bus (local)
      Change Fee (paid by traveller)
      Excess baggage / weight (paid by traveller)
      Miscellaneous Charge Order (prepaid)
      Miscellaneous Charge Order (not prepaid)
      Rail - next higher class to economy class (standard)
      Taxi chit utilized (do not enter charge)
      Taxi receipts
      Commercial - Other
      Motorcycle - rental
      Motorcycle - helmet rental
      Other mode of transportation
      Private / leased aircraft
      Snowmobile - rental
      Snowmobile - insurance (not otherwise covered)
      Snowmobile - privately owned
      Snowmobile - helmet rental
      Watercraft - privately owned
      Watercraft - insurance (not otherwise covered)
      Watercraft - rental
      Crown owned and/or leased vehicle
      Insurance charge (not otherwise covered)
      Vehicle - Other
      Private motor vehicle -  to public carrier/ return trip home
      Private motor vehicle (Appendix B kilometric rate)
      Private motor vehicle - pick-up at public carrier/ return trip home
      Rental - drop-off charge
      Rental - fuel charge
      Rental - Insurance charge
      Rental - compact
      Rental - mid-size (standard)
      Rental - large (non-standard)
      Rental - Other
      Rental - Insurance charge
      Rental - Provincial Sales Tax
      Rental - Quebec Sales tax
      Rental - Harmonized Sales Tax
      Rental - Goods and Services Tax